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Wyoming rates for HCPCS 64494

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.08 / $1,105.15 / $2,835.75
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,077.52 / $1,077.52 / $1,210.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.09 / $95.05 / $3,000.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$73.52 / $139.50 / $228.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.00 / $163.00 / $295.00
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$151.50 / $274.50 / $442.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.64 / $120.68 / $212.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.97 / $176.23 / $299.01